This week House Republican leaders unveiled the American Health Care Act, legislation that repeals and replaces the Affordable Care Act (ACA), or Obamacare.

In my view, the ACA has fallen well short of its own stated goals to expand choices, increase access to care, and reduce costs. That is why I voted to repeal all or parts of it numerous times. All across the country insurance providers are leaving the ACA-created exchanges, resulting in less choice and higher costs. In Virginia, premium rates may increase as much as 16 percent, according to the Richmond Times-Dispatch.

It is clear that we can do better. And we can do better by putting the patient and health care provider – not the government – at the center of our health care system.

Next, the committees with jurisdiction over health care issues – mainly Ways and Means and Energy and Commerce – will begin “marking up” or amending the legislation. This process is already underway.

Eventually a bill or bills will come to the House floor for a vote. But before we get to that point, I will be evaluating this legislation in the days ahead to determine if it will be good for Virginians. I will apply to the bill my five principles for replacing the Affordable Care Act to determine if it will win my support. I’ve listed them below.

1) All Virginians should be able to purchase health insurance coverage.

2) Choice and access must be prioritized and maintained.

3) We need to get serious about reducing health care costs.

4) Medicare and Medicaid must be protected and preserved.

5) We need to create a system that empowers individuals and the private sector, not one that grows government.

My initial thoughts are that while this bill contains some provisions I support, I do have deep concerns about the lack of details on how many people will be covered under this legislation and what the overall costs will be.

One thing that is very important to me is that I continue to hear from you about the ACA repeal and replace plan. You can send your thoughts to me by emailing ACAIdeas.VA01@mail.house.gov

This is a topic I expect to address in upcoming telephone town hall meetings, and so if you would like to receive a call to join the next one, click here. I also hope you’ll take a moment to sign up for my weekly email updates, which will contain news on this and other topics highlighting my work on your behalf.

I look forward to hearing from you, and it’s an honor to serve you and Virginia’s First District in the People’s House.

Members of the House Freedom Caucus stood with Sen. Rand Paul (R.-Ky.) Tuesday to denounce the Obamacare replacement bill supported by House Speaker Paul Ryan (R.-Wis.) and to announce the filing of Paul’s own bill, which is sponsored in the House by Rep. Jim Jordan (R.-Ohio). (continued here)

Where do I stand on the matter? The problem is that Obamacare has damaged the insurance markets. So I am not exactly certain what would happen with a straight up repeal. My guess is that where there is only one insurer prices would climb (as they already have), but eliminating Obamacare would encourage competition. So things would soon get back to where they were before the Obamacare mess. So I would like to see Obamacare repealed.

Frankly, however, I don’t understand the reconciliation process. Speaker Ryan makes the point that he cannot put everything wants in the bill because of the reconciliation process (which allows the bill to pass with a simple majority in the Senate). Nevertheless, Ryan never says what could be done with reconciliation. So I wonder if a clean repeal is possible. It is something I will have to look into.

What about the folks with preexisting conditions and over aged children who want to stay on their parents healthcare and other such things that Obamacare was supposed to fix? I am sort of puzzled as to why people think government is suppose to fix problems like that. If you don’t understand why, then I would like you to explain why the national debt is growing like mad. In addition, I would to hear you explain why it is moral for some people to vote to make other people pay their personal bills.

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23 thoughts on “INFORMATION WE NEED FOR THE DEBATE ON REPEALING AND REPLACING OBAMACARE”

“I am sort of puzzled as to why people think government is suppose to fix problems like that.” You are puzzled as to why people think that the government should prevent insurance companies from discriminating against people? Also, such things don’t affect the national debt as they weren’t funded by subsidies but merely additions to the law. But sure, why not allow companies to deny coverage to a pregnant woman transitioning between jobs or her husband transitioning between jobs? I mean, that will certainly make sure abortions go down, right? People are certainly going to choose life when they find out that they have to pay even more to have children. That will get people to say no to abortion, right?

And don’t forget the elderly! I am sure that people will push against right-to-die legislation when they find out that keeping grandma alive will cost them a mortgage payment a week. What better way to undermine the euthanasia argument than by cutting coverage and raising premiums on the elderly and terminally ill!

If paying more money in taxes means a single child is saved, then I would do it wholeheartedly. I know that my charitable donations do so that isn’t an issue. But if my taxes can save even one life, then it has been worth everything. If you don’t think so, then please tell me how much a pound of flesh is worth, Shylock?

Discriminating against people? Because they have a preexisting condition? That is absurd! You don’t know the meaning of insurance.

Thanks to such idiocy, Congress has so warped the business model for healthcare the insurance companies cannot make a profit. So the stupid system is imploding. Medicare and Medicaid are driving the deficit. Medicaid expanded under Obamacare.

Congressional legislation, BTW, through the tax code causes people to tie healthcare to their jobs. State laws limit insurance coverage (and competition) across state boundaries. You want to straighten out our healthcare system? Then stop trying to fix it with government, and rely competition and plain-old charity.

Is it absurd to say that insurance companies discriminate when they deny coverage to someone who is pregnant when they apply for coverage? For someone who decries Marxism, you seem to have a penchant for reducing people to mere money relations.

“Medicaid expanded under Obamacare.” And as a result, abortion rates fell among low income families with greater expansions and affordability of prenatal care. Weird, huh? Again I ask, how many abortions will be prevented when women find out they can’t get health care coverage because they are pregnant? Go on, answer the question honestly. How many do you think will be prevented when faced with the choice of thousand of dollars of medical bills and zero healthcare until you well past the post partum stage, or $500 procedure that is already covered and was already covered by most insurance companies to make that “problem” go away?

You do know that the state lines thing is a crock of fools gold, right? There has never been an honest study that has ever shown that allowing insurance to be bought over state lines would do anything. Also, if it is state law that prohibits it, why would you want federal law to cancel out the laws of the states?

The state lines thing is a crock of fools gold? Competition forces people to innovation and keep their prices down if they want to stay in business. That does not work in the medical business? You have to have a study?
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Selling across state lines also allows insurance companies to dodge state regulation and effectively eliminate the consumers ability to be treated fairly.

You see, as with all insurance, regulation happens mostly at the state level. This makes sense for compliance sake since Virginia and Maryland, for example, have different laws on the subject.

Take Virginia’s auto insurance mandate of a minimum $20k bodily injury and property damage coverage. It is based on the way the Virginia judiciary is set up. Enter a policy from a state with higher minimum policy limits and you effectively prevent most suits from ever going before the GDC and has to be immediately filed in the Circuit.

State regulate different because each one has different needs and different laws.

Seeing as I never made that argument, you can take your straw man back to the barn.

Also, I am always amazed at the way liberals denounce any expert opinion. I can imagine someone on the Titanic yelling, “Yeah the ‘experts’ say we hit an iceberg but I don’t think they know what they are talking about.”Why no liberal has attempted neurosurgery without the expert qualifications is probably just a matter of time and not common sense.

I’ve taken the most absurd proposition, shown arguments from people who would know what they are talking about, and shown it to be effectively pointless to the actual issue at hand. It is the great bridge to nowhere that the GOP seems to roll out as some Brass Serpent in the desert.

Did you notice that they are getting rid of the mandate….sort of? And that much of Obamacare came from the Heritage Foundation, especially the individual mandate? Basically, they are merely cutting the subsidies and Medicaid expansions and keeping everything else.

Socialism would be government ownership of industry. What we have is no where near effective socialism. If it were, then companies wouldn’t have been able to withdraw from the market; the state would have been able to force companies to belong. Also, saying our healthcare is effectively socialism doesn’t hold up unless you also believe that our cars are also socialist because we have to buy car insurance.

You have taken the most absurd position? Well, I can’t disagree with that.

So you must be right. We don’t need the free enterprise system or competition of any sort. So we can just put the government in charge, of everything, and we can all just happily drive Yugos.

Seriously, all you are doing is sniping. I am not certain what is possible with budget reconciliation, but they cannot repeal Obamacare in its entirety. The The thing about the Heritage Foundation is old news. They changed their mind for the same reason I changed mine. Socialized medicine creates more problems than it solves.

Right, which is a stupid way to work since it is essentially treating people the same way we treat cars. For the ideological groups that pounds podiums about how Marxism is terrible, you sure do reduce people to dialectic materialism a lot.

One of the effects that I’ve seen from the Affordable Care Act has been companies that give their employees the choice of either (1) going from full time to part time or (2) being let go due to “workforce reduction.” So if they want to have a paycheck, they must give up their company-sponsored benefits and rely on an Affordable Care Act Plan which is then subsidized because they are only making part time wages.

Two part time employees are hired to do the job of one full time employee. This is called “being flexible for the employees so that they can maintain a balance between work and personal life.” It is actually just saving the company money that would be spent towards claims and plan maintenance. I really don’t want that to sound like an angry rant, but it sort of is, and although this hasn’t happened to me, it has happened to people that I know. (Anyway, thanks for letting me rant!)

the bottom line is that someone is going to have to pay for this…and that shall be you and me my friend…and nobody seems to “get” that—that we the taxpayers will pay-we will have to pay for the over costs that others will not be paying for –because nothing is free when it comes to our government….

I once saw a video of an illegal alien female happily marveling at how “everything is free” in America. I have my doubts about just how genuine the video really was, but for those who don’t pay taxes “everything is free”. Who doesn’t pay some kind of taxes?

While I’m willing to political the process play out and see what the final bill looks like after all the horse trading, I have to say I am disappointed with the bill in its raw form

Republicans and Trump in particular were elected to repeal the disastrous ObamaCare and replace it with something that would do three things: 1.Drive down premiums/deductibles 2. Enhance the freedom of individuals to buy (or not buy) health insurance best suited to their own needs 3. Reduce the overall cost t the government so we can at least pretend we are not headed towards fiscal implosion for a little while.

I don’t think it’s accomplished any of these things, regardless of what CBO numbers say because the CBO is ALWAYS wrong.

First, the subsidies and Medicaid reductions they say will kick in at the start of an election year (2020) will never happen. Second, the lack of introducing true competition in to the healthcare market ( people must still purchase insurance within their own state, insurers must still cover pre existing conditions and “kids” up to 26 years old can still be under their parents’ plan). Third, they didn’t re introduce the option to buy low premium/high deductible/ limited coverage plans for catastrophic coverage which ObamaCare made illegal.

It’s ObamaCare Lite, which I hope will change dramatically after the negotiations.

Thanks for the comment. I am not happy about it, but I will probably end up supporting some variation of Ryan’s bill. I just hope it gets better and not worse.

Part of the problem is that the Democrats can still stop the Republicans from passing a bill. Still need 60 votes in the Senate. So what Speaker Ryan wants to do is use the Budget Reconciliation process to amend what he can of Obamacare. Budget Reconciliation only requires a simple majority, but it is only designed to reconcile legislation so that the House and Senate can vote on the same bills. Thus, the Congressional Budget Act permits using reconciliation only for those things that changes spending, revenues, and the federal debt limit. What exactly does that mean? Well, we do have a bunch of lawyers running the country. So I am certain the leadership games the system, but I expect they try to avoid being too obvious.

Anyway, for what it is worth I intend to write a post on this. Still not there, but I am slowly reaching the conclusion that we have two problems. The first is that Budget Reconciliation is not a panacea. If we can get half a loaf from it, that is better than none. The second is that we have too many people in this country who want something for nothing, and these think our government owes them. These people don’t vote for Conservatives. So there is no point in expecting Congress to act like it is full of Conservatives. It ain’t.

What can we do? If we want to retain our republic, we have to start thinking long term. It is not enough to just dig in our heels. We have to constantly fight for legislation that nibbles away the almighty state. In addition, we have to reeducate the foolish people who want something for nothing. That includes getting rid of public education.

There is no easy fix. It took generations to reach this state of affairs. It will take generations to restore our republic — if we can.

“I hope we once again have reminded people that man is not free unless government is limited. There’s a clear cause and effect here that is as neat and predictable as a law of physics: as government expands, liberty contracts.” Ronald Reagan.